Points in the history

Features of the cough:

• duration
• constant or intermittent
• productive or dry cough
• if sputum - nature of sputum:
  • yellow - suggestive of infection or asthma
  • large amounts of green sputum is suggestive of bronchiectasis
  • pneumococcal pneumonia is suggested by rusty sputum
• haemoptysis:
  • frank haemoptysis or recurrent small haemoptyses may occur in non-infective coughs e.g. lung cancer
  • infection may present with blood-streaked sputum
  • pulmonary oedema may cause pink, frothy sputum
• timing:
  • a night-time cough suggests asthma or cardiovascular disease; asthma may also present with an exercise-related cough

Associated factors:

• acute infection is often accompanied by fever and malaise
• wheezing occurs in asthma, COPD and pulmonary oedema
• chest pain
  • pleuritic chest pain occurs in infection and infarction
• malignancy and tuberculosis should be considered if the patient is suffering from weight loss, anorexia, night sweats
• a smoking history should be recorded
• occupational history
• history of allergy
• drug history e.g. ACE inhibitors can cause a dry cough